The legacy of slavery and the socialization of Black female health and human services workforce members in addressing social determinants of health

BACKGROUND: One legacy of slavery and colonialist structures is that minority populations, particularly the Black populations, experience higher rates of poverty, disease, job insecurity, and housing instability today - all indicators of poor health or negative social determinants of health (SDOH). While the historical legacy of slavery may explain why certain populations currently experience social determinants, they may also embody Post Traumatic Slave Syndrome (PTSS) through manifestations of negative health outcomes. MATERIAL AND METHODS: Black female health and human services (HHS) workforce members, who have taken SDOH trainings through a medical-legal partnership (MLP), were recruited for an ethnographic study to determine how historical context, specifically PTSS, can help Black female HHS workforce members understand and advocate for their patients as well as challenge the medial and legal institutions. RESULTS: Themes emerged around how Black women in HHS have persisted and resisted, struggled, and strived to protect and raise a resistant community that is perpetually threatened. Black women constantly exist in the past, present, and future, negotiating their identities and reproducing the modeled behavior of the parents, particularly their Black mothers, who taught them how to exist in the world as Black women. CONCLUSIONS: As sufferers of negative social determinants, Black women, especially those working in HHS, use their lived experiences and historical trauma to challenge the systems within which they work. They use their intersectional identities and their reimagined definitions of SDOH to rethink how the HHS workforce can move forward in working in the best interests of their patients. Future SDOH trainings may consider integrating historical legacies to challenge medical-legal institutions.